HomeMy WebLinkAbout1969-01-09 Permit, Water Supply System #2041Village Permit No 2041
Contractor r, — 04 S GtlF A dress L% z c� r2 Or �� n
Owner Fj-t, /i
State License No---------- — Village License No. —_—
GENERAL PERMIT
VILLAGE OF ORONO
Crystal Bay, Minnesota
Date Z- e7_ 4 %
Section No Parcel No. Lot Block —_ Subdivision —
Plat No
Other Description:
I hereby agree that. in rase a permit is granted, all work which shall he clone and all materials which stall be used, shall
comply with the Village Code of Orono applicable thereto, and shall include all additional specifications as listed beloay.
Install plumbing systems:
Install
In r sewage disposal systems
aRe
s
wafer supply systems:
Repair
Fee $
Fee $ --
1. ee $ /0 - O O-
- -- ---- — . Fee $--
Total amount paid to Village........ $ — __ _ _._--
Signature of applicant
Signature of Villa Official